DR Palak Dengla, HOD-Physiotherapy, Aster RV Hospital
Do you wake up in pain or do you wake up fresh and energized the next morning, especially during a hotel stay?? Extremely soft/Dunlop pillows and mattresses are found in hotels, which instead of comfort, hamper the spine more. The Goal of sleeping at night is to rejuvenate and to get rid of the toxicities accumulated throughout the day. One should off load oneself from all the tensions and stresses mentally and physically to get a good night’s sleep and wake up revitalized. It is shown that 35% of people wake up with spinal pains during their sleep. Sleep Science recommends the spine to be in neutral/natural curvature while sleeping, wherein the head, neck and spine should fall in a straight line to reduce the undue biomechanical stress on the spine.
Sleep posture is an example of a sustained physical risk factor that is modifiable. Gordon et al reported increased neck stiffness, headaches, scapular and arm pains with faulty sleep alignments. Additionally, sleep regulates daily living and the cognitive ability, judgment, and memory that are needed at work. Schutz has stated that the quality of sleep is directly related to human health as well as standard of living. Chronic neck issues associated with sleepless nights have shown to increase in recent years.
Steps to follow to achieve Right Sleep Ergonomics:
1. Type of Pillow: Pillow and mattress ideally should not be extremely soft or hard, it should be firm enough to support and obliterate the natural curves of the spine in the night and restore complete rest to them. They should not sink in to take the shape of our body. The assisting muscles should get a chance to come back to their original length which can happen only when we support them instead of pushing them to work constantly due to a faulty posture. Preferred Pillow type is a firm cotton or an ergonomic latex pillow of around 10 cm in height.
2. Position of the Pillow: Scientific Research on Sleep Ergonomics, shows that pillow should not only be under the head and neck area, but also should be under the uppermost part of your shoulder blades (spine of scapula). Importantly, your head should be in neutral when you lie on a pillow, it should not go for a forward flexion or a back extension as if sinking back.
3. Additional Pillows:
Ø Straight Sleeper/Supine lying: Add a pillow under the lower neck and upper shoulder area separately, to ease extra load on the shoulder muscles. Add a folded squared Turkish towel under the lower back and a soft pillow or a towel roll under the knees to ease the lower back muscles. Supine lying is considered a better position for low back lumbar pain.
Ø Side Sleeper: Add a small soft cushion/pillow under the thoracic rib cage in a side-lying position. This helps in getting a neutral curve at the whole spine, also abates any kind of shoulder pain if present. Additionally, a pillow can be used in between the knees and another one under the top arm, so that you can comfortably sleep like a baby. In my experience, patients with neck pain do well in the side lying position.
Orthopaedic pillows and mattresses are quite trending, but we need to be sure about their genuineness, and practicality of usage as many of them are a marketing gimmick and cost ineffective.
· Things to avoid:
Ø Supporting the head with your hand under the head while sleeping. If required, increase the height of your pillow by using a folded towel.
Ø Keeping shoulder overhead, it can pinch the nerves of your spine leading to neck and arm pain.
Ø Sleeping in the same position throughout the night. Keep changing the position every 2 hrs or so.
Ø Neck should not be forward flexed or sinking back in extension while using a pillow. It should be in a neutral position, with well supported spinal arches.
Ø Strictly avoid sleeping on your stomach/prone lying as research shows that it increases the spinal tissue load drastically, waking up individuals with spinal pain.
Thus, an appropriate selection of pillows can optimize the sleeping posture and help facilitate high-quality sleep. Consult your Physiotherapist for the right type and size of the mattress and pillow according to your body biomechanics to have a blissful night.